1.09 Module One Wellness Plan
Directions: Fill in all logs and answer the reflection questions completely with supporting details and then submit this complete file to 1.09 Module One Wellness Plan Assessment.

Section 1: Goals
Include your goals for each area of wellness before completing the reflection question. Be sure that each goal is Measureable, Attainable, and has a specific Deadline (MAD). Also, be sure each goal is written in complete sentences. 

Physical - 
Social - 
Emotional - 
Academic – 

Goal Reflection Question: Which of your wellness goals is the most important to you? Explain why.
Answer:

Section 2: Target Heart Rate
My resting heart rate is ______   bpm.
My target heart rate zone is _____ bpm to _____ bpm.

Heart Rate Reflection Question: Were you able to maintain your workouts within your calculated target heart rate zone? Explain which activities you enjoyed most and which best helped you stay in your THR zone.

Answer:

Section 3: Fitness Assessments

Activity	Lesson 1.03
Baseline Results	Module 1
Wellness Plan Results	Module 2
Wellness Plan Results	Module 3
Wellness Plan Results	
Mile Run/Walk					
Body Mass Index 					
Aerobic Capacity					
Curl-ups 					
Push-ups 					
Trunk Lift					
Sit and Reach 					
 
(Scroll Down)

Fitness Assessment Reflection Questions: 
1. Explain how you feel about your above scores when compared to the Healthy Fitness Zone Standards (Standards are at the end of this document).
Answer:
2. Explain how your activity routine is improving each of your health-related components of fitness (flexibility, muscular strength and endurance, cardiovascular, and body composition)? 
Answer:

Section 4: Physical Activity Log

Include all moderate and vigorous physical activity in the table below. You need at least 8 different dated entries with at least 3 different moderate to vigorous activities that add up to 420 minutes. Keep adding rows to show all of your activities. Activates need to add up to 420 minutes (not including warm-ups).

Date	Warm-up	Physical Activity	Activity Minutes without Warm-up	

				

				

				

				

				

				
	TOTAL: 420 Minutes	

Physical Activity Reflection Question:  Explain how you have applied or will apply each of the FITT principles in your workouts. 

F - 
 I - 
T - 
T –
(Scroll Down)

Section 5: Fitness Tracker Data

Please record your MOVband data here. If you do not have a MOVband, you can use this formula:

1.)	Average daily moves this week = Total number of physical activity minutes for the last 7 days x 26.19
2.)	Percent toward my goal this week = Total average daily moves ÷ by 12,000
3.)       Total moves this week = Total number of physical activity minutes for the last 7 days x 183.33 

	Module 1
Wellness Plan Results	Module 2
Wellness Plan Results	Module 3
Wellness Plan Results	
Average Daily Moves This Week				
% Toward My Goal this Week				
Total Moves This Week				

MOVband Reflection Question: Discuss changes you can make in your workout routine to increase your activity participation and improve on your achievements. Include adjustments to completed activities and activities you may wish to add to your routine.

Answer:

(Scroll Down for Fitness Standards & Grading Rubric)

Fitness Assessment Standards for Females

Aerobic Capacity
One-Mile Run / Walk
VO2max (ml/kg/min)	Body Composition
Body Mass Index
 	
Age	Needs Improvement Health Risk	Needs Improvement	Healthy Fitness Zone	Needs Improvement Health Risk	Needs Improvement	Healthy Fitness Zone	Very Lean	
12	≤ 37.0	37.1 – 40.0	≥ 40.1	≥ 25.8	≥ 22.2	22.1 – 15.2	≤ 15.1	
13	≤ 36.6	36.7 – 39.6	≥ 39.7	≥ 26.8	≥ 23.0	22.9 – 15.7	≤ 15.6	
14	≤ 36.3	36.4 – 39.3	≥ 39.4	≥ 27.7	≥ 23.7	23.6 – 16.2	≤ 16.1	
15	≤ 36.0	36.1 – 39.0	≥ 39.1	≥ 28.5	≥ 24.4	24.3 – 16.7	≤ 16.6	
16	≤ 35.8	35.9 – 38.8	≥ 38.9	≥ 29.3	≥ 24.9	24.8 – 17.1	≤ 17.0	
17	≤ 35.7	35.8 – 38.7	≥ 38.8	≥ 30.0	≥ 25.0	24.9 – 17.5	≤ 17.4	
17+	≤ 35.3	35.4 – 38.5	≥ 38.6	≥ 30.0	≥ 25.0	24.9 – 17.8	≤ 17.7	

 	Abdominal Strength and Endurance	Trunk Extensor Strength and Flexibility	Upper Body Strength and Endurance	Flexibility	
 	Curl-Up	Trunk Lift	90° Push-Up	Back-Saver Sit & Reach	
 	# completed	# of inches	# completed	# of inches	
Age	up to max of 75	up to max of 12	up to max of 75	up to max of 12	
12	≥ 18	9 – 12	≥ 7	10	
13	≥ 18	9 – 12	≥ 7	10	
14	≥ 18	9 – 12	≥ 7	10	
15	≥ 18	9 – 12	≥ 7	12	
16	≥ 18	9 – 12	≥ 7	12	
17	≥ 18	9 – 12	≥ 7	12	
17+	≥ 18	9 – 12	≥ 7	12	

Key
Healthy Fitness Zone (HFZ): Results at this level indicate you have sufficient fitness for good health. Your fitness plan should focus on maintaining or continuing to improve your fitness level.

Needs Improvement (NI): Results at this level indicate you have moderate fitness in some or all areas. You should set goals and design your exercise routines to work toward the Healthy Fitness Zone levels in each fitness category.

Needs Improvement-Health Risk (NI-Health Risk): Results at this level indicate increased health risks. You should work with parents or other adults to design a fitness and nutrition plan to help you work toward better fitness and overall health.

Fitness Assessment Standards for Males

Aerobic Capacity
One-Mile Run / Walk
VO2max (ml/kg/min)	Body Composition
Body Mass Index
 	
Age	Needs Improvement Health Risk	Needs Improvement	Healthy Fitness Zone	Needs Improvement Health Risk	Needs Improvement	Healthy Fitness Zone	Very Lean	
12	≤ 37.6	37.7 – 40.2	≥ 40.3	≥ 24.7	≥ 21.4	21.3 – 15.3	≤ 15.2	
13	≤ 38.6	38.7 – 41.0	≥ 41.1	≥ 25.6	≥ 22.3	22.2 – 15.8	≤ 15.7	
14	≤ 39.6	39.7 – 42.4	≥ 42.5	≥ 26.5	≥ 23.1	23.0 – 16.4	≤ 16.3	
15	≤ 40.6	40.7 – 43.5	≥ 43.6	≥ 27.2	≥ 23.8	23.7 – 16.9	≤ 16.8	
16	≤ 41.0	41.1 – 44.0	≥ 44.1	≥ 27.9	≥ 24.6	24.5 – 17.5	≤ 17.4	
17	≤ 41.2	41.3 – 44.1	≥ 44.2	≥ 28.6	≥ 25.0	24.9 – 18.1	≤ 18.0	
17+	≤ 41.2	41.3 – 44.2	≥ 44.3	≥ 29.3	≥ 25.0	24.9 – 18.6	≤ 18.5	

 	Abdominal Strength and Endurance	Trunk Extensor Strength and Flexibility	Upper Body Strength and Endurance	Flexibility	
 	Curl-Up	Trunk Lift	90° Push-Up	Back-Saver Sit & Reach	
 	# completed	# of inches	# completed	# of inches	
Age	up to max of 75	up to max of 12	up to max of 75	up to max of 12	
12	≥ 18	9 – 12	≥ 10	8	
13	≥ 21	9 – 12	≥ 12	8	
14	≥ 24	9 – 12	≥ 14	8	
15	≥ 24	9 – 12	≥ 16	8	
16	≥ 24	9 – 12	≥ 18	8	
17	≥ 24	9 – 12	≥ 18	8	
17+	≥ 24	9 – 12	≥ 18	8

Key
Healthy Fitness Zone (HFZ): Results at this level indicate you have sufficient fitness for good health. Your fitness plan should focus on maintaining or continuing to improve your fitness level.

Needs Improvement (NI): Results at this level indicate you have moderate fitness in some or all areas. You should set goals and design your exercise routines to work toward the Healthy Fitness Zone levels in each fitness category.

Needs Improvement-Health Risk (NI-Health Risk): Results at this level indicate increased health risks. You should work with parents or other adults to design a fitness and nutrition plan to help you work toward better fitness and overall health.

1.09 Module One Wellness Plan Grading Rubric – 140pts
 	Excellent	Good	Needs Improvement
	Poor	
Section 1: Goals	10 points
•	Goals are given for all four wellness areas.
•	Reflection question responses are thoughtfully detailed and supported.	8 points
•	Goals are given for all four wellness areas.
•	Reflection responses are adequately detailed and supported.	6 points
•	Goals are given for all four of the wellness areas.
•	Reflection responses are complete but lacking detail and support.	0-4 points
•	One or more of the wellness goals are missing.
•	Reflection responses are incomplete or inaccurate.	
Section 2: Target Heart Rate	10 points
•	Heart rate and target heart rate zone are recorded and accurate.
•	Reflection question responses are thoughtfully detailed and supported.	8 points
•	Heart rate and target heart rate zone are recorded and slightly inaccurate.
•	Reflection responses are adequately detailed and supported.	6 points
•	Heart rate and target heart rate zone are recorded and moderately inaccurate.
•	Reflection responses are complete but lacking detail and support.	0-4 points
•	Heart rate and target heart rate zone are not recorded and/or completely inaccurate.
•	Reflection responses are incomplete or inaccurate. 	
Section 3: Fitness Assessments	20 points
•	Fitness assessment results are recorded.
•	Reflection question responses are thoughtfully detailed and supported.	16 points
•	Fitness assessment results are recorded.
•	Reflection responses are adequately detailed and supported. 	12 points
•	Fitness assessment results are recorded.
•	Reflection responses are complete but lacking detail and support. 	0-8 points
•	Fitness assessment results are recorded.
•	Reflection responses are incomplete or inaccurate.
	
Section 4: Physical Activity Log
YOU ARE REQUIRED TO LOG AT LEAST 420 ACTIVITY MINUTES.	40 points
•	At least eight activity entries are listed.
•	At least three different exercises have been logged, including exercises specific to the current topic when required.
•	All exercises are moderate to vigorous intensity.
•	All exercises are dated as daily or every other day.
•	Reflection question responses are thoughtfully detailed and supported.

	35 points
•	At least six activity entries are listed.
•	At least three different exercises have been logged, including exercises specific to the current topic when required.
•	Most exercises are moderate to vigorous intensity.
•	Most exercise dates are listed, or all dates are not in an effective pattern.
•	Reflection responses areadequately detailed and supported.	30 points
•	At least four activity entries are listed.
•	At least two different exercises have been logged, including exercises specific to the current topic when required.
•	Some exercises are moderate to vigorous intensity.
•	Some exercise dates are listed.
•	Reflection responses are complete but lacking detail and support.

	0-20 points
•	Less than four activity entries are listed.
•	One type of exercise has been logged, including exercises specific to the current topic when required.
•	Few exercises moderate to vigorous intensity, or intensity is not indicated.
•	Few exercise dates are listed.
•	Reflection responses are incomplete or inaccurate.

	
Section 5: Fitness Tracker Data	40 points
•	Average daily moves, percent toward goal, and total moves for the week are recorded.
•	Reflection question responses are thoughtfully detailed and supported.	35 points
•	Average daily moves, percent toward goal, and total moves for the week are recorded.
•	Reflection responses are adequately detailed and supported.	30 points
•	Average daily moves, percent toward goal, and total moves for the week are recorded.
•	Reflection responses are complete but lacking detail and support.	0-20 points
•	One or more of the fitness tracker data is missing.
•	Reflection responses are incomplete or inaccurate.

	
Presentation	20 points
•	Plan format is properly followed.
•	All responses are in the form of complete sentences.
•	No spelling errors.	16 points
•	One or two errors in plan format.
•	Most responses are in the form of complete sentences.
•	One or two spelling errors.	12 points
•	Three errors in plan format.
•	Some responses are in the form of complete sentences.
•	Three spelling errors.
	0-8 points
•	Four or more errors in plan format.
•	Few responses are in the form of complete sentences.
•	Four or more spelling errors.	
Total Points Possible: 140 points